Provider Demographics
NPI:1801411798
Name:CARELLO, DEBORAH (BS, CADC, LLMSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:CARELLO
Suffix:
Gender:F
Credentials:BS, CADC, LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W SPRING ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4661
Mailing Address - Country:US
Mailing Address - Phone:069-225-1181
Mailing Address - Fax:906-225-7203
Practice Address - Street 1:200 W SPRING ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4661
Practice Address - Country:US
Practice Address - Phone:069-225-1181
Practice Address - Fax:906-225-7203
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)